An overview of current evaluation methods of postgraduate dental specialty residents

PURPOSE

A lack of contemporary dental literature exists on evaluating dental residents in postgraduate education, with no standardized criteria or information on technology adoption. This study aims to understand current evaluation methods in dental residency programs and compare them to existing literature.

METHODS

A survey with 22 questions was sent to program directors of 749 ADA/CODA (American Dental Association/Commission on Dental Accreditation)-accredited postgraduate dental residencies. The questions focused on evaluation frequency, faculty involvement, submission methods, and electronic software usage.

RESULTS

The survey response rate was 30.2% (226 responses). Results show that 98% of program directors are involved in evaluations, but require more support from auxiliary faculty. Evaluations are typically submitted twice or four times a year, with 12% of programs wanting increased frequency. Face-to-face delivery of feedback is considered crucial. While desktop computers are widely used for evaluation submission, 55% of programs utilize mobile devices, which correlates with higher program director satisfaction. The most popular evaluation software includes New Innovations, MEd Hub, and Qualtrics. Overall, 86.96% of program directors are satisfied with current evaluation practices. Areas needing improvement are non-program director faculty involvement, resident response/feedback, and software navigation.

CONCLUSION

This study found that a majority of program directors of the postgraduate dental education system are using electronic technology for their resident evaluation systems and are satisfied with their current mechanism of evaluation.

Faculty Development for Metro New York City Postdoctoral Dental Program Directors: Delphi Assessment and Program Response

Faculty development for dental academicians is essential to cultivate a continuous faculty workforce, retain existing faculty members, enhance their teaching skill sets, and remain responsive to changing program requirements and curricular reforms. To maximize the utility of dental faculty development, it is important to systematically assess and address faculty members' perceived training needs. The aims of this study were to determine priority topics among one group of postdoctoral program directors and to translate those topics into faculty development programs as part of Columbia University's Health Resources and Services Administration (HRSA)-sponsored faculty training program for primary care educators. The study was conducted in 2013-16. A Delphi consensus technique was implemented with three sequential surveys of 26 New York City metropolitan area general, pediatric, and public health dentistry residency program directors. On the first survey, the five respondents (19% response rate) identified 31 topics. On the second survey, 17 respondents (response rate 65%) rated the 15 most important topics. In the third and final round, 19 respondents (73% response rate) ranked teaching research methods and teaching literature reviews as the topics of greatest interest. Overall, the responses highlighted needs for faculty development on teaching research methods, motivating trainees, trainee evaluation, and clinical care assessment. Based on these results, a series of six Faculty Forums was developed and implemented for dental educators in the metropolitan area, starting with the topic of teaching research methods. The process flow used for assessing training needs and developing and evaluating training can be applied to a variety of populations of educators.

The Effect of Awareness of American Board of Orthodontics Criteria on Treatment Outcomes in a Postgraduate Dental Clinic

The aims of this study were to evaluate the posttreatment outcomes in a postgraduate orthodontic clinic following a course on American Board of Orthodontics Cast and Radiograph Evaluation (ABO-CRE); to compare the outcomes of postgraduate students who took the course before and after finishing treatment of their cases; and to assess if the need for orthodontic treatment as determined by the Index of Orthodontic Treatment Need (IOTN) at the beginning of treatment affected students' final scores. A course on ABO-CRE was given to second- (group A), third- (group B), and fourth- (group C) year postgraduate students at Yeditepe University, Istanbul, Turkey, in 2012. Pre- and posttreatment plaster models of 253 cases (group A) were treated by students in 2011-12. An additional 251 (group B, 2012-13) and 341 (group C, 2013-14) cases were evaluated in the first and second years after the course, respectively. The models were graded retrospectively using the ABO-CRE and IOTN. The results showed that the total mean scores on the posttreatment plaster models were significantly higher in the pre-course group than the first- and second-year post-course group (p<0.05 and p<0.01, respectively). The borderline cases (grade 3) received a lower score on the ABO-CRE than the cases with need (grade 4) (p<0.01) and severe need (grade 5) (p<0.01) for orthodontic treatment. Increasing awareness by giving information about the ABO-CRE significantly improved the posttreatment success of these postgraduate students. After the course, treatment outcomes in the following year were better than two years later, suggesting it may be useful to teach the course annually to refresh students' knowledge.

Postgraduate Orthodontics Students' and Mentors' Perceptions of Portfolios and Discussion as Tools for Development of Reflection

The aim of this study was to analyze the effects of a portfolio learning strategy designed to develop students' reflection abilities in a postgraduate orthodontic program in the UK. Nine first-year postgraduate orthodontic students and seven mentors participated in the one-year program, which included a reflective portfolio, mentorship, and discussion. After the program, the students' and mentors' perceptions were collected using focus groups and individual interviews, respectively. The data were analyzed using thematic analysis. Four categories emerged. The first, reflection, was considered a skill to learn, and time was needed for students to fully understand its meaning and achieve its outcomes. The second theme, characteristics of reflection, was descriptive at the beginning and more critical at the end of the experience. The third theme, outcomes of reflection, involved students' improved problem-solving and action-planning abilities and increased self-awareness, motivation, confidence, and communication skills. In the fourth theme, stimulation of reflection, students did not agree with mentors regarding the importance of reflective writing, but they recognized the value of the portfolio's reflective log in facilitating the reflective process. There was greater agreement between students and mentors regarding discussions with mentors and among peers as tools to achieve higher levels of reflection. Overall, these students and mentors considered the strategy an effective tool for improving students' reflection.

Identifying Multilevel Barriers to Tobacco Intervention in Postdoctoral Dental Education

The aims of this mixed-methods study were to assess tobacco treatment behaviors among residents and faculty in dental specialty postdoctoral programs and to explore factors in training and practice related to tobacco treatment education. Surveys and focus groups were conducted with a convenience sample of participants at three postdoctoral residency programs in New York City. Surveys assessed tobacco cessation training and behaviors. Focus groups explored barriers to implementing tobacco cessation treatment in educational settings. Data were collected between May and December 2013. Among the 160 faculty and residents identified as potentially eligible for the study, 60 were invited by program directors to participate, and 50 subsequently completed the survey and participated in a focus group (response rate of 31.3%). Survey results indicated high levels of asking patients about tobacco use and advising patients to quit. In contrast, specific tobacco cessation assistance and follow-up care occurred less frequently. There were statistically significant differences in tobacco cessation intervention across the specialties surveyed, but not between residents and faculty. Focus group comments were grouped into three broad areas: clinician factors, organizational support, and structural and contextual factors. Focus group results indicated that participants experienced significant organizational and structural barriers to learning about and providing tobacco treatment. Participants from each specialty indicated that multi-level barriers impeded their provision of evidence-based tobacco cessation interventions in postdoctoral educational settings. They suggested that didactic education should be reinforced by organizational- and systems-level changes to facilitate comprehensive tobacco education and effective cessation treatment in future dental practice.

Creating a new generation of pediatric dentists: a paradigm shift in training

The University of California, Los Angeles (UCLA) School of Dentistry has implemented a Health Resources and Services Administration-funded program to prepare dentists for the complex and comprehensive needs of pediatric patients within rapidly changing demographics and a paradigm shift in dentistry. Traditional dental education has focused on how to respond to oral disease, whereas UCLA's program shifts the paradigm to emphasize early assessment, risk-based prevention, and disease management. A holistic approach to dental care that considers social and environmental determinants is used with minimally invasive techniques for restorative care. To support this change, pediatric dental residents receive traditional training combined with new didactics, advocacy opportunities, and applied learning experiences at community-based organizations. These new elements teach residents to recognize the causal factors of disease and to identify interventions that promote oral health at the individual, family, community, and policy level. Consequently, they are better prepared to treat a diverse group of patients who historically have faced the greatest burden of disease as well as an increased number of barriers to accessing oral health care; these consist of low-income, minority, and/or pediatric populations including children with special health needs. The program's ultimate goal is for residents to deploy these skills in treating vulnerable populations and to demonstrate greater interest in collaborating with non-dental health providers and community organizations to increase access to dental services in private or public health practice settings.

An interdisciplinary, team-based design for an oral and maxillofacial radiology course for postdoctoral dental students

This article describes the transition of an oral and maxillofacial radiology course from a traditional lecture format to an interactive case-based, team-based, interdisciplinary, and intraprofessional learning model in advanced dental education. Forty-four postdoctoral dental students were enrolled in the course over a twelve-week period in the fall semester 2012. The class consisted of U.S.- and foreign-trained dentists enrolled in advanced education programs in various dental disciplines. The course faculty preassigned interdisciplinary teams with four or five students in each. The class met once a week for an hour. Ten of the twelve sessions consisted of a team presentation, individual quiz, team quiz, and case discussion. Each member of a team completed peer evaluation of other team members during weeks six and twelve of the course. The final course grade was a composite of individual and team quiz grades, team presentation, and peer evaluation grades. The overall class average was 90.43. Ninety-five percent of the class (42/44) had total team grades equal to or greater than total individual quiz grades. The objective of creating a new case-based, team-based, interdisciplinary, intraprofessional learning model in advanced dental education was achieved, and the initial student perception of the new format was positive.

Comparing face-to-face, synchronous, and asynchronous learning: postgraduate dental resident preferences

The Department of Dental Medicine of Lutheran Medical Center has developed an asynchronous online curriculum consisting of prerecorded PowerPoint presentations with audio explanations. The focus of this study was to evaluate if the new asynchronous format satisfied the educational needs of the residents compared to traditional lecture (face-to-face) and synchronous (distance learning) formats. Lectures were delivered to 219 dental residents employing face-to-face and synchronous formats, as well as the new asynchronous format; 169 (77 percent) participated in the study. Outcomes were assessed with pretests, posttests, and individual lecture surveys. Results found the residents preferred face-to-face and asynchronous formats to the synchronous format in terms of effectiveness and clarity of presentations. This preference was directly related to the residents' perception of how well the technology worked in each format. The residents also rated the quality of student-instructor and student-student interactions in the synchronous and asynchronous formats significantly higher after taking the lecture series than they did before taking it. However, they rated the face-to-face format as significantly more conducive to student-instructor and student-student interaction. While the study found technology had a major impact on the efficacy of this curricular model, the results suggest that the asynchronous format can be an effective way to teach a postgraduate course.

Benefits of externships with pediatric dentistry programs for potential residents: program directors' and current residents' perceptions

This study's goal was to understand the extent, framework, and benefits of externships with prospective residency programs undertaken by predoctoral dental students or dentists interested in applying for a residency program. In 2012, a questionnaire was sent to all pediatric dentistry residents and program directors in the United States (63 percent and 74 percent return rate, respectively). Externships were offered by fifty-seven of the seventy-six programs. Most program directors (95 percent) agreed that externships are beneficial and compensate at least partially for the lack of numerical National Board Dental Examination scores or class rankings. Among the responding residents, 61 percent were female. The top reasons given by residents for choosing to extern with a certain program were its location and perceived reputation. Of the 249 respondents who did an externship, 47 percent externed with their current program. The acceptance rate into the number one choice of program was similar among those who did an externship vs. those who did not (73 percent vs. 75 percent). No relationship was found between gender and externships among the 341 respondents who were accepted into their top choice. Most of the residents (98.8 percent) felt that completing an externship was beneficial, and 88 percent got an increased understanding for the differences between university- and non-university-based residency programs.

Effect of a rotation training system on the mental health status of postgraduate dental trainees at Kyushu University Hospital, Fukuoka, Japan

In Japan, the increasing frequency of mental health problems in postgraduate dental trainees has recently become apparent. To our knowledge, there has been no previous research to investigate the influence of the type of training program on the mental health of dental residents during one year of postgraduate clinical training. Therefore, the purpose of this study was to compare changes in the mental health of two groups of dental trainees at Kyushu University Hospital, Fukuoka, Japan: those who undertook a rotation training program and those who trained solely in one department (the control group). Study subjects in both groups completed the Profile of Mood States (POMS) and the General Health Questionnaire (GHQ) at five intervals throughout the postgraduate training year. Analysis of the questionnaire responses were performed by Student's t-test, analysis of variance, Bonferroni's test, and the chi-square test. Statistical tests showed differences in the mean scores of POMS-30 subscales and GHQ-28. The mood of anger was the factor that seemed to best describe the trainees' response to stress. The study results led to the conclusion that dental trainees' mental health is influenced by the type of training program and that dental trainees in rotation training programs may need more mental health support.

Reducing oral and maxillofacial surgery resident risk exposure: lessons from graduate medical education reform

It is estimated that, in the United States, more than 40,000 patients are injured each day because of preventable medical errors. Although numerous studies examine the causes of medical trainee errors and efforts to mitigate patient injuries in this population, little research exists on adverse events experienced by oral and maxillofacial surgery (OMFS) residents or strategies to improve patient safety awareness in OMFS residency programs. The authors conducted a retrospective literature review of contemporary studies on medical trainees' reported risk exposure and the impact of integrating evidence-based patient safety training into residency curricula. A review of the literature suggests that OMFS residents face similar risks as medical trainees in medical, surgical, and anesthesia residency programs and may benefit from integrating competency-based safety training in the OMFS residency curriculum. OMFS trainees face particular challenges when transitioning from dental student to surgical resident, particularly related to their limited clinical exposure to high-reliability organizations, which may place them at higher risk than other medical trainees. OMFS educators should establish resident competence in patient safety principles and system improvement strategies throughout the training period.